Serial extraction

Serial extraction is the planned extraction of certain deciduous teeth and specific permanent teeth in an orderly sequence and predetermined pattern to guide the erupting permanent teeth into a more favorable position. Serial extraction is the planned extraction of certain deciduous teeth and specific permanent teeth in an orderly sequence and predetermined pattern to guide the erupting permanent teeth into a more favorable position. In 1929, Kjellgren of Sweden used the term 'serial extraction' for the first time. In the 1940s the technique was popularised in the United States by Hayes Nance as “planned and progressive extraction”. Nance is known as the Father of serial extraction in the United States. In 1970 Hotz in Switzerland called it active 'supervision of teeth by extraction'. There is no fixed technique to be followed while carrying out serial extractions. Careful diagnosis and continuous re-evaluation during the course of treatment is mandatory to achieve required results. However based on the usual eruption sequence of teeth, deciduous canines are extracted at the age of 8–9 years to create space for proper alignment of incisors, followed by extraction of deciduous first molars a year later so that the eruption of first premolars is accelerated and lastly extraction of the erupting first premolars to give space for the alignment of permanent canines. In some cases a modified technique is followed in which the first premolars are enucleated at the time of extraction of the deciduous first molar. This modification is frequently necessary in the mandibular arch where the canines often erupt before the first premolars. Extracting the primary canines only – it produces rapid self-improvement in incisor crowding and alignment intercepting the development of lingual crossbite of the lateral incisors.